What Makes People on Shrooms Jump Off Buildings and Die?

Earlier this month, a student from Singapore tripping on shrooms in a Bali hotel jumped five floors to his death. The news recalled an incident from a year ago, when a 23-year old banker at Merrill Lynch had plunged 26 stories after eating some magic mushrooms. These tragic stories are familiar; a quick Google search reveals dozens of similar incidents that have happened over the years, stories that are inevitably used to demonize the drug. Indeed, as a police narcotics source told the New York Post after last year's death, "when you take these mushrooms, they make you hallucinate and, in some cases, if you take enough of them they make you believe that you can fly like Superman."

There's no question that shrooms can make you see things that aren't there, just as there is no question that people have been killed or seriously injured while under the influence of psilocybin, the psychoactive compound in magic mushrooms. But just last week, the annual Global Drug Survey reported that mushrooms are the safest of any drug used recreationally. Of the 120,000 people surveyed, 12,000 had used mushrooms in 2016, but only 0.2 percent of them required emergency medical care as a result. This rate is 5 to 6 times lower than substances like LSD, cocaine, MDMA, and alcohol, and 3 times lower than marijuana.

So are shrooms going to make you trip so hard that you think you can fly, or walk across a busy intersection unscathed, or are you really safer eating some golden caps than going down to the bar?

The answer is that it really depends on the individual and the specific circumstances in which they consume the hallucinogen. According to most psychedelic researchers, people with a family history of schizophrenia or bipolar disorder are more likely to have a serious, adverse reaction to hallucinogenic compounds.

When hallucinogens were first being studied in the 1950s and '60s, researchers were profoundly interested in their relationship to schizophrenia and psychosis. According to The Guardian, between 1950 and 1965 some 40,000 patients had been prescribed some form of LSD therapy for the treatment of neurosis, schizophrenia and psychopathy.

When I spoke with Darrick May, a researcher at Johns Hopkins focusing on psychiatric uses of psilocybin and psychedelic harm reduction, he noted that hallucinogens such as LSD and DMT were originally called "psychotomimetics" because they were thought to be capable of mimicking the effects of a psychotic or schizophrenic episode.

May said that this assumption has since been debunked, but that he and his colleagues at Johns Hopkins still exercise an abundance of caution when they screen individuals for their psilocybin research. He added that there is no evidence for a causal link between the onset of schizophrenia and hallucinogenic compounds, and that the interactions between psilocybin and the brain are too poorly understood to begin to trace the neural mechanisms involved in psychotic psilocybin episodes.

This was also echoed by Bob Jesse, one of the co-authors on the recent Johns Hopkins study on psilocybin bad trips. The largest ever study of its kind, some 2,000 volunteers self-reported their difficult experiences with psilocybin using a rigorous online questionnaire. Yet in spite of its thoroughness, the study wasn't able to predict bad trips based on any demographic factors or pre-existing mental health histories.

"These incidents occur so rarely so we don't really know what factors significantly contribute to causing them," May says. "It's just known that people with schizophrenia can have prolonged reactions and worse outcomes." Still, the experiences he and other researchers have had working in psychedelic harm reduction tents at festivals like Burning Man suggest it's better to be safe than sorry.

"In those cases we don't know [a patient's] history," May says. "Someone with schizophrenia in their personal or family history comes to Burning Man or some event, uses a psychedelic and has a psychotic episode that doesn't end. So in our studies we screen out people who have a history of psychosis or schizophrenia. That's one of the most important steps."

Unfortunately, the relationship between shroom trips and mental breakdowns is likely to remain obscure for some time to come. As the Global Drug Survey pointed out, very rarely are people admitted to the hospital for toxic levels of psilocybin. Most deadly incidents appear to be the result of dangerous environments, adverse reactions based on pre-existing mental health issues, or mixing the psilocybin with other substances.

Moreover, studying adverse reactions in any scientifically rigorous sense is difficult because lab conditions significantly reduce the likelihood of any subjects having a bad trip. "In today's laboratory studies, well-screened volunteers receive psilocybin under the constant supervision of competent 'guides' or 'monitors' who are there for reassurance and to help if a volunteer becomes agitated," Jesse says. "Nonetheless, current wisdom in the field is that anyone with a personal history of schizophrenia or bipolar disorder should not take a psychedelic."

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